Congress is voting today on a massive spending bill, $1.1 trillion in discretionary spending. Some government programs will see their budgets increase for the first time since the sequester, but increase is a relative term. Money for the National Institutes of Health, for example, will go up by a billion dollars from the 2013 level. That's far from where it was before the sequester.

HOBSON: Well, so, a billion-dollar increase from 2013, what does that really mean for the NIH?

ROVNER: Well, certainly, it's better, as you said, than last year, when they were taking a $700-million hit. But, you know, between 1998 and 2003, NIH saw its budget doubled. It went up to about $27 billion. And now, of course, it's just under 30. So, in that, you know, in the decade since - a little more than a decade - it's barely kept up with inflation. In fact, it really hasn't kept with inflation, and that's really one of the problems, say the leaders of the nation's biomedical research enterprise, is that it's just not keeping up.

HOBSON: Well, what do they say they won't be able to do, as a result of this?

ROVNER: Well, last year, of course, with the sequester, there was a cut of 640 research grants. Now, with these billion dollars, they say that they'll be able to fund 385 more research grants. But really, what's happening is that around the country, people who get funded by NIH - and that's much of the biomedical research establishment - are having to cut back. They're having to try to do more with less. It means, you know, fewer resources, fewer people to help, you know, work in these labs and, really, less consistency. They don't know how to plan. They don't know how to look out into the future. It's hard to fund research, you know, in one-year increments. And there just hasn't been anything, any consistency in the funding at NIH that nobody can really plan out their research enterprises. That's been the big problem here.

HOBSON: Well, we've heard lots of stories about people saying that the U.S. is falling behind, that the director of the NIH said last year, the U.S. is falling behind in terms of medical research of because of this.

ROVNER: That's right. And that's exactly the problem, is that, you know, we're training all of these young scientists, but they're really worried about going into, you know, labs that are funded by the NIH, because they're not sure that they count on them. They're not sure that they can, you know, raise a family, that these are jobs that have a future. They may want to go into private labs or private enterprise, because they're just not sure that these jobs with a future, if the funding isn't stable. And right now, the funding just has not been growing, and has not been stable. And that's a big problem for the NIH.

HOBSON: Although the fact that they were spared budget cuts and are getting this billion-dollar increase, does that show that Washington is getting that message?

ROVNER: A little bit, but I think there's still a concern that, you know, it's barely enough to cover last year's cut, and not enough to keep things really going, and certainly not enough to move ahead in - you know, science grows. Science needs to move forward, and there's just not enough to really keep that going ahead. That was something that, you know, basically, the doubling of NIH was something that came at the behest of Republicans. It was a bipartisan effort, and now it's really just stalled out.

HOBSON: Julie, usually, when we talk to you on this show, it's about the Affordable Care Act. There's so much to talk about there. Are there any changes in the omnibus bill to the level of funding for the ACA?

ROVNER: Surprisingly few. You know, this had been the Republican effort to just cut, cut, cut, stop funding. You know, there were fights of blocking the bill. There were some very small cuts in this omnibus bill, for instance, things like rescinding funding for a board - a controversial Medicare payment board that haven't even been appointed yet. But this is the first time that money has been allocated for a prevention and public health fund. It actually looked like a cut, but it really isn't. That's been kind of a piggy bank Congress has used to cut funds from other things. That actually has been allocated for the first time. So, really not as bad as a lot of people had thought.